LAUSR

In the past pulmonary interstitial emphysema (PIE) was considered a frequent complication in mechanical ventilated newborns but, with the use of antenatal steroids, surfactant administration and lung-protective ventilation, its incidence has fallen over the years. While the association with prematurity, low birthweight and mechanical ventilation is well established, this condition can spontaneously occur in non-ventilated and full-term newborns. PIE results from overdistension and disruption of the alveoli membrane leaking air into the pulmonary interstitium, reducing lung distensibility. This condition can eventually progress with further dissection and rupture of the visceral pleura. PIE can be classified as acute or persistent, according to its duration, and diffuse or localised, depending on the affected tissue. Unilateral emphysema causes mediastinal shift and compression of the contralateral lung, which leads to the need for higher ventilatory pressures, overdistension and ultimately resulting in an aggravated cycle of events. PIE treatment can range from conservative measures and selective unilateral ventilation to high-frequency ventilation, extracorporeal membrane oxygenation or lobectomy in severe cases. Case Report